# Accelerometer-derived “weekend warrior” physical activity pattern and risk of age-related eye diseases: a prospective cohort study

## TL;DR

This study finds that doing most of your weekly physical activity on weekends, known as the 'weekend warrior' pattern, can still protect against age-related eye diseases, similar to regular daily activity.

## Contribution

The study is the first to show that concentrated weekend physical activity reduces eye disease risk as effectively as regular activity.

## Key findings

- Weekend warrior activity reduced cataract risk by 11% compared to inactivity.
- The weekend pattern also lowered risks of diabetic retinopathy and macular degeneration.
- No significant differences were found between weekend and regular activity for most eye diseases.

## Abstract

International guidelines recommend at least 150 min of weekly moderate-to-vigorous physical activity (MVPA), but whether concentrated versus distributed activity patterns differ in their associations with age-related eye diseases remains unclear.

This prospective cohort study included 86,271 UK Biobank participants free of age-related eye diseases at baseline. Physical activity was assessed using wrist-mounted triaxial accelerometers (Axivity AX3) over seven consecutive days. Two MVPA thresholds were examined: ≥ 150 min/week (primary) and ≥ 300 min/week (secondary). Participants were categorized as: inactive (below threshold), weekend warriors (WW; meeting threshold with ≥ 50% MVPA concentrated within 1–2 days), or regularly active (meeting threshold without WW criteria). Cox proportional hazards regression models were used to assess associations over a median follow-up of 7.9 years.

At the ≥ 150 min/week threshold, both WW (hazard ratio [HR] = 0.89, 95% confidence interval [CI]: 0.84–0.94, P < 0.001) and regularly active patterns (HR = 0.93, 95% CI: 0.87–0.99, P = 0.028) were associated with a reduced risk of cataract compared to inactivity. The WW pattern was also associated with a reduced risk of diabetic retinopathy (DR, HR = 0.74, 95% CI: 0.55–0.99, P = 0.043) and age-related macular degeneration (AMD, HR = 0.85, 95% CI: 0.75–0.97, P = 0.016). Direct comparisons between the WW and regularly active patterns showed no significant differences for these conditions (all P > 0.05), except for a nominal difference in glaucoma (P = 0.036). At the ≥ 300 min/week threshold, only the WW pattern remained significantly associated with reduced risk of cataract (HR = 0.91, 95% CI: 0.86–0.97, P = 0.002) and glaucoma (HR = 0.86, 95% CI: 0.75–0.97, P = 0.019).

Both the WW and regularly active patterns demonstrate protective associations with age-related eye diseases compared to inactivity, with no statistically significant differences between the two active groups for most outcomes. These findings suggest that the WW approach is a viable and flexible alternative for individuals who find it difficult to maintain daily physical activity.

The online version contains supplementary material available at 10.1186/s40662-026-00480-6.